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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIZU OLYMPUS CO., LTD. BRONCHOVIDEOSCOPE

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AIZU OLYMPUS CO., LTD. BRONCHOVIDEOSCOPE Back to Search Results
Model Number BF-P150
Medical Device Problem Code Detachment of Device or Device Component (2907)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/04/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was returned to olympus for inspection.Additionally, the investigation found: the adhesive on the bending section cover (a-rubber) is detached.Based on the results of the investigation, the root cause of the reported event could not be determined/identified.Should additional relevant information become available, a supplemental report will be submitted.Olympus will continue to monitor field performance for this device.
 
Event or Problem Description
It was observed that during the device evaluation, the bronchovideoscope exhibited that the adhesive on the bending section cover (a-rubber) is detached.There were no reports of patient involvement.
 
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Brand Name
BRONCHOVIDEOSCOPE
Common Device Name
BRONCHOVIDEOSCOPE
Manufacturer (Section D)
AIZU OLYMPUS CO., LTD.
3-1-1 niiderakita
aizuwakamatsu-shi, fukushima 965-8 520
JA  965-8520
Manufacturer (Section G)
AIZU OLYMPUS CO., LTD.
3-1-1 niiderakita
aizuwakamatsu-shi, fukushima 965-8 520
JA   965-8520
Manufacturer Contact
todd brill
800 west park drive
westborough, MA 01581
5082077661
MDR Report Key23358135
Report Number9610595-2025-27089
Device Sequence Number21073988
Product Code EOQ
UDI-Device Identifier04953170308178
UDI-Public04953170308178
Combination Product (Y/N)N
PMA/510(K) Number
K023984
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 10/22/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Other
Device Model NumberBF-P150
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/04/2025
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 10/04/2025
Initial Report FDA Received Date10/22/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/11/2011
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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